HB 2949

                                SECOND REGULAR SESSION
                   HOUSE BILL NO. 2949
                          103RD GENERAL ASSEMBLY
                           INTRODUCED BY REPRESENTATIVE DOLL.
6629H.01I  JOSEPH ENGLER, Chief Clerk
                                           AN ACT
To amend chapter 160, RSMo, by adding thereto one new section relating to sudden cardiac
      arrest screening.
Be it enacted by the General Assembly of the state of Missouri, as follows:
       Section A. Chapter 160, RSMo, is amended by adding thereto one new section, to be
2 known as section 160.484, to read as follows:
       160.484. 1. This section shall be known and may be cited as the "Sudden
2 Cardiac Arrest Screening Act".
32. As used in this section, the following terms mean:
4(1) "Athletic activity" includes, but is not limited to, the following:
5(a) Interscholastic athletics at a public or private school offering instruction to
6 students in kindergarten through grade twelve;
7(b) Any athletic contest or competition, other than interscholastic athletics, that
8 is sponsored by or associated with a school entity including, but not limited to, club-
9 sponsored sports activities;
10(c) Competitive or noncompetitive cheerleading that is sponsored by or
11 associated with a school entity; and
12(d) Any practice, scrimmage, or interschool practice related to activities listed in
13 paragraphs (a) to (c) of this subdivision;
14(2) "Department", the state department of elementary and secondary education;
15(3) "MSHSAA", the Missouri State High School Activities Association;
EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language.
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16(4) "Qualified medical professional", a licensed physician, licensed physician
17 assistant, nurse practitioner, certified athletic trainer, or cardiologist trained in
18 recognizing and treating cardiac conditions in athletes;
19(5) "Student athlete", a student who:
20(a) Is enrolled in a public or private school offering instruction to students in
21 kindergarten through grade twelve; and
22(b) Participates in any athletic activity.
233. (1) For the 2027-28 school year and all subsequent school years, the
24 department, in collaboration with the state department of health and senior services and
25 MSHSAA, shall distribute educational materials that follow evidence-based science to
26 inform and educate student athletes, parents and guardians, and coaches about the
27 diseases that can cause sudden cardiac arrest and the nature and warning signs of
28 sudden cardiac arrest including, but not limited to, the risks associated with continuing
29 to participate in or practice an athletic activity after experiencing symptoms. Such
30 educational materials shall be distributed annually in conjunction with a student
31 athlete's preparticipation physical examination and completion of the required
32 permission forms.
33(2) (a) For the 2027-28 school year and all subsequent school years, before any
34 student athlete participates in any athletic activity, the student athlete and such student
35 athlete's parent or guardian shall sign and return to the student athlete's school the
36 required acknowledgment form acknowledging the receipt and review of such
37 educational materials.
38(b) The state department of health and senior services, in collaboration with
39 MSHSAA, shall develop such acknowledgment form for MSHSAA's member schools.
40 As part of the student athlete's eligibility requirements, a new acknowledgment form
41 shall be signed and returned to the applicable school at the beginning of each school
42 year in which the student athlete intends to participate in an athletic activity. Each
43 acknowledgment form shall be stored in the school's online eligibility software program.
44(3) The department, the state department of health and senior services, and
45 MSHSAA shall post any educational materials distributed under this section on each
46 entity's publicly accessible website.
474. (1) For the 2027-28 school year and all subsequent school years, each coach of
48 an athletic activity shall annually complete a cardiac arrest training course provided by
49 MSHSAA or a qualified provider for its member schools. The training shall be
50 approved by the school board.
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51(2) The training shall be in correlation with any other training required by the
52 relevant school association related to cardiopulmonary resuscitation (CPR) and
53 automated external defibrillators (AEDs).
54(3) A coach of an athletic activity shall not be eligible to coach in a practice or
55 competition until such coach has completed the training course required under this
56 section.
575. (1) For the 2027-28 school year and all subsequent school years, a qualified
58 medical professional who performs a physical examination for student athletes shall
59 include a cardiovascular prescreening that follows nationally recognized, evidence-
60 based guidelines recommended by organizations focused on cardiovascular care in
61 pediatric populations.
62(2) Key prescreening elements shall include a targeted personal history, targeted
63 family history, and a focused physical examination to detect or raise suspicion for
64 cardiovascular disease and shall incorporate at least the following elements:
65(a) For personal history, prior elevated systemic blood pressure, unexplained
66 exertional chest pain or syncope, palpitations, or decreased exercise tolerance;
67(b) For family history, known cardiac conditions such as cardiomyopathy,
68 arrhythmia syndromes, premature sudden cardiac death, and unexplained drowning or
69 seizures; and
70(c) For physical examination, detection of a pathologic heart murmur, irregular
71 rhythm, abnormal pulses, or other findings suggestive of structural or electrical heart
72 disease.
73(3) Athletes with positive findings shall be referred to a cardiologist for further
74 evaluation and testing.
75(4) Prescreening shall take place within the three months before the first day of
76 the school year in which the athletic season takes place.
77(5) (a) The state department of health and senior services shall compile and
78 publish on its website an annual report containing the total number of examinations
79 that were completed and the number of referrals that were made to cardiology. The
80 report shall analyze the outcomes under this section and be made publicly available.
81(b) Monitoring shall record the total number of screenings including, but not
82 limited to, utilization and uptake by clinicians, proportion of positive screens and
83 follow-up, and, where possible, data regarding the follow-up including, but not limited
84 to, false positive rates, and additional diagnostic studies.
856. Qualified medical professionals who perform a physical examination for
86 student athletes as required under this section shall increase knowledge of prescreening
87 guidelines through policies, programs, training, and continuing education implemented
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88 by the state board of registration for the healing arts and the Missouri state board of
89 nursing. Such policies, programs, training, and continuing education shall include, but
90 not be limited to:
91(1) How to complete the cardiovascular risk assessment including, but not
92 limited to, collecting family history and personal reports of symptoms;
93(2) Identifying early signs of cardiac arrest through physical examination; and
94(3) Referral procedures for positive findings.
957. The department shall promulgate all necessary rules and regulations for the
96 administration of this section. Any rule or portion of a rule, as that term is defined in
97 section 536.010, that is created under the authority delegated in this section shall
98 become effective only if it complies with and is subject to all of the provisions of chapter
99 536 and, if applicable, section 536.028. This section and chapter 536 are nonseverable
100 and if any of the powers vested with the general assembly pursuant to chapter 536 to
101 review, to delay the effective date, or to disapprove and annul a rule are subsequently
102 held unconstitutional, then the grant of rulemaking authority and any rule proposed or
103 adopted after the effective date of this section shall be invalid and void.
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